UPF consumption higher in rural vs urban areas among US adults

A US study has observed greater consumption of ultraprocessed food (UPF) among adults living in rural areas than those in urban areas, with a few significant differences by urbanization among youth.

Researchers analysed cross-sectional data from the National Health and Nutrition Examination Survey from 2013 to March 2020. They estimated the mean percent of total energy and total gram intakes from Nova categories (minimally processed foods [MPF], processed culinary ingredients, processed foods, and UPFs) by urbanization level (nonmetropolitan statistical areas [non-MSAs; n=3,976], small-to-medium MSAs [n=9,170], and large MSAs (n=14,637]) for youth aged 2‒19 years and adults aged ≥20 years.

Orthogonal contrasts in linear regression models were used to assess trends by urbanization level, with adjustments for age, sex, race and Hispanic origin, and income. Day 1 dietary sample weights accounted for differential probabilities of selection, nonresponse, noncoverage, and day of the week.

No trend was observed in MPF or UPF as a percent of energy by the urbanization level among youth. MPF increased while UPF decreased, as a percent of grams, with a higher level of urbanization. Only the trend in the percent of grams from MPF persisted following adjustments for covariates.

In adults, MPF increased and UPF decreased with higher urbanization levels as both a percent of energy and of grams. These trends persisted following adjustments for covariates.

“In the US, UPFs may contribute to poorer diet quality that has been observed in rural areas compared with urban areas, as increased UPF consumption is linked with decreased nutritional quality,” the researchers said.